Rethinking population shrinkage in the Australian context: a new research agenda

Whilst the study on the impact of shrinkage is well documented in North America and Europe, the effects of population-driven shrinkage on rural and regional communities in Australia is comparatively under-researched. This is despite existing literature on the volatility of population change in regional and rural Australia. Therefore, there is cause for establishing a typology of shrinkage in the Australian context, unpacking the different and complex economic, social and environmental causes and consequences, and therefore impacts, and establishing a framework for ongoing research. In this paper, we set out the rationale for this typology, indicating how population drivers are not only extensive, but further complicated by the as-yet-unknown impacts of COVID-19 and teleworking. Regarding policy solutions, we suggest that while mindsets are increasingly changing from a need to reverse population trends to, instead, embracing opportunities and alternative futures for many regional and rural Australian towns, we need to first establish a typology of population shrinkage that is reflective of the Australian context to ensure policy responses are locally appropriate. Practitioner pointers - Mindsets around planning policies on the impacts of population-driven shrinkage are beginning to shift towards understanding the specific socio-economic circumstances of the localised area and adopting appropriate policy instruments accordingly. - To support this nascent shift, establishing a typology of shrinkage that is reflective of the Australian context is key. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

A scoping review of live wildlife trade in markets worldwide.

Wet markets sell fresh food and are a global phenomenon. They are important for food security in many regions worldwide but have come under scrutiny due to their potential role in the emergence of infectious diseases. The sale of live wildlife has been highlighted as a particular risk, and the World Health Organisation has called for the banning of live, wild-caught mammalian species in markets unless risk assessment and effective regulations are in place. Following PRISMA guidelines, we conducted a global scoping review of peer-reviewed information about the sale of live, terrestrial wildlife in markets that are likely to sell fresh food, and collated data about the characteristics of such markets, activities involving live wildlife, the species sold, their purpose, and animal, human, and environmental health risks that were identified. Of the 56 peer-reviewed records within scope, only 25% (n = 14) focussed on disease risks; the rest focused on the impact of wildlife sale on conservation. Although there were some global patterns (for example, the types of markets and purpose of sale of wildlife), there was wide diversity and huge epistemic uncertainty in all aspects associated with live, terrestrial wildlife sale in markets such that the feasibility of accurate assessment of the risk of emerging infectious disease associated with live wildlife trade in markets is currently limited. Given the value of both wet markets and wildlife trade and the need to support food affordability and accessibility, conservation, public health, and the social and economic aspects of livelihoods of often vulnerable people, there are major information gaps that need to be addressed to develop evidence-based policy in this environment. This review identifies these gaps and provides a foundation from which information for risk assessments can be collected.

A retrospective cohort study of bladder cancer following the COVID-19 pandemic: Are patients presenting with more aggressive disease?

Background The COVID-19 pandemic has resulted in delays in the treatment of patients with urological malignancies. The management of bladder cancer (BC) in particular poses a significant challenge given the recurrent nature of the disease and the intense follow-up regime required for many cases. The aim of this study was to evaluate potential changes in the presentation and operative management of BC in our hospital following the pandemic. Materials and methods This is a retrospective cohort study. Potential BC cases were identified through the histopathology database between March 2019 and February 2021. Details were obtained on patient demographics, procedure type such as biopsy, resection or excision, grade and stage of BC. Cases were divided into two groups: period one (pre-COVID between March 2019 and February 2020) and period two (post-COVID between March 2020 and February 2021). Results A total of 207 procedures for confirmed BC were performed during the study period, 126 in period one and 81 in period two. New cases accounted for 52.4% (n = 66) and 53.1% (n = 43) of cases during periods one and two respectively. There was a higher rate of invasive disease (43.2% vs 26.2%) as well as high grade disease (47.4% vs 35.8%) in period two than in period one. Conclusion Fewer BC procedures were performed in the COVID period. The higher rate of more advanced stage and grade of disease seen in period two suggests patients are presenting later. This should be considered when allocating resources in the management of non-COVID related diseases. Further studies are needed to assess the long-term impact of COVID-19 on bladder cancer outcome.

Educating health professionals about COVID-19 with ECHO telementoring

Background: When the COVID-19 pandemic began, primary care clinicians had almost no knowledge regarding best practices COVID-19 treatment. Project ECHO developed a COVID-19 Infectious Disease Office Hours (Office Hours) program to respond to the needs of clinicians seeking COVID-19 information. Methods: This mixed-methods evaluation analyzed weekly post-session data and focus group results from the weekly Office Hours ECHO sessions during June 1, 2020-May 31, 2021. Results: A total of 1,421 participants attended an average of 4.9 sessions during the 45 Office Hours sessions studied. The most common specialties included: nurses= 530 (37%), physicians= 284 (20%), and 493 (34%) having other degrees. The participants stated that they were definitely (68.2%) or probably (22.0%) going to use what they learned in their work, especially vaccination information. Focus group results identified these themes: 1) quality information, 2) community of practice, 3) interprofessional learning, and 4) increased knowledge, confidence, and practice change. Conclusions: This evaluation demonstrates that the Office Hours program was successful in bringing a large group of health professionals together each week in a virtual community of practice. The participants acknowledged their plans to use the information gained with their patients. This diffusion of knowledge from clinician to patient amplifies the response of the program, changes practice behavior and may improve patient care. (c) 2021 The Author(s). Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

The 5 senses program: A patientcentered family engagement strategy

INTRODUCTION: Patients admitted to pediatric intensive care units (PICU) often experience sensory deprivation and develop maladaptive sensory disorders. Simultaneously, families often endorse feelings of helplessness and fear while their child is critically ill. This study aims to expand ICU family engagement in a unique, patient-centered manner. METHODS: This is a single-centered prospective cohort study performed at a quaternary PICU. Inclusion criteria included age >12 months, were mechanically ventilated, and with a Glasgow Coma Scale < 10. Exclusion criteria included those with baseline cognitive or developmental delay, palliative concerns, or to clinically unstable. The team consisted of occupational therapists and speechlanguage pathologists. Once enrolled, the team created an individualized sensory plan, including any existing sensory needs or aversions. The therapist oriented the family to the program and provided stimulation to all 5 senses. The family was provided an informational handout and a sensory kit to encourage stimulation when the therapist was not present. Following ICU discharge, the families were surveyed regarding their experience. RESULTS: From June 2019 through July 2021, 15 patients were enrolled and 12 completed surveys. Age ranged from 15 months to 17 years with a mean age of 7.6 years. The most common diagnosis was traumatic brain injury (n=5, 33%). All surveyed families provided stimulation at least 3 times following ICU transfer. 92% (n=11) participants provided stimulation more than once a day. Reported difficulty level was labeled as easy (n=9, 69%) or medium (n=3, 23%). CONCLUSIONS: Sensory stimulation can augment recovery and prevent new sensory integration disorders. These targeted plans and environmental modifications have been shown to aid in delirium prevention, family engagement, and non-pharmacologic soothing. Overall, we found that families and caregivers enjoyed the guided engagement and provided very positive feedback. There were several limitations to this project. Primarily, due to the COVID-19 pandemic, the average daily PICU census was very low, inhibiting enrollment ability. Additionally, there was difficulty obtaining consults for the therapist team, thus delaying enrollment. We hope to continue to enroll patients and expand our program to other hospital units.

Experiential learning placements in primary care: Responding to the COVID-19 pandemic

In 2020, the Sars-2-CoV pandemic led to challenges in providing experiential learning (EL) placements for undergraduate student pharmacists in primary care settings across Scotland. The need to reduce footfall along with the introduction of physical distancing measures, a blended approach to working location, and a change to workflow, all created unforeseen challenges for hosting student pharmacist EL placements within the primary care environment in NHS Lanarkshire. This short report focuses on how the primary care prescribing support team in NHS Lanarkshire adapted student pharmacist EL placements to ensure they continued to meet learning outcomes as defined by the universities via virtual delivery hosted on MS Teams.

The Effects of Loaded Plyometrics and Short Sprints in U19 Male Soccer Players in Tunisia

Featured Application The investigation examined adding 8 weeks of bi-weekly loaded plyometric and short sprints training into standard training for U19 soccer players. We report that including bi-weekly loaded plyometric and short sprints training in standard training during the coronavirus-19 (COVID-19) pandemic improved the physical fitness of young soccer players. Particularly, the ability to repeatedly change direction benefited most from the intervention. We investigated adding 8 weeks of bi-weekly loaded plyometric and short sprints (LPaSS) training into training for under 19 (U19) soccer players. An experimental group (EG, n = 18, age: 17.5 +/- 0.58 years, body mass: 67.4 +/- 4.37 kg, height: 1.76 +/- 0.05 m, body fat: 11.4 +/- 1.55%), and a control group (CG, n = 16, age: 17.5 +/- 0.58 years, body mass: 68.7 +/- 3.65 kg, height: 1.78 +/- 0.03 m, body fat: 11.6 +/- 1.14%) participated. The pre- and postintervention measures were: the squat-jump (SJ);the countermovement-jump with arm swing (CMJA);the five jump test (5JT);10 m and 30 m sprint;the ability to change direction (sprint with 90 degrees turns (S90 degrees) and sprinting 9-3-6-3-9 m, involving running both backwards and forwards (SBF);repeated sprint ability (RSA), and balance (Y-balance test). The EG experienced superior jump (p < 0.001;d(range): 1.69-1.89), sprint (p < 0.001;d(range): 1.82-2.56), S90 degrees (p < 0.001;d(range): 1.64-2.25), RSA (p < 0.001;d(range): 3.90-4.17), and balance (p < 0.001;d(range): 1.11-2.54) improvement. Comparatively, the pre- to postchanges in the CG ranged from d = 0.36 (dynamic balance) to d = 1.00 (10 m sprint). Therefore, bi-weekly LPaSS training improves athletic performance in young soccer players, particularly RSA.

Changes in air quality in Mexico City, London and Delhi in response to various stages and levels of lockdowns and easing of restrictions during COVID-19 pandemic.

The impacts of COVID-19 lockdown restrictions have provided a valuable global experiment into the extent of improvements in air quality possible with reductions in vehicle movements. Mexico City, London and Delhi all share the problem of air quality failing WHO guideline limits, each with unique situations and influencing factors. We determine, discuss and compare the air quality changes across these cities during the COVID-19, to understand how the findings may support future improvements in their air quality and associated health of citizens. We analysed ground-level PM10, PM2.5, NO2, O3 and CO changes in each city for the period 1st January to August 31, 2020 under different phases of lockdown, with respect to daily average concentrations over the same period for 2017 to 2019. We found major reductions in PM10, PM2.5, NO2 and CO across the three cities for the lockdown phases and increases in O3 in London and Mexico City but not Delhi. The differences were due to the O3 production criteria across the cities, for Delhi production depends on the VOC-limited photochemical regime. Levels of reductions were commensurate with the degree of lockdown. In Mexico City, the greatest reduction in measured concentration was in CO in the initial lockdown phase (40%), in London the greatest decrease was for NO2 in the later part of the lockdown (49%), and in Delhi the greatest decrease was in PM10, and PM2.5 in the initial lockdown phase (61% and 50%, respectively). Reduction in pollutant concentrations agreed with reductions in vehicle movements. In the initial lockdown phase vehicle movements reduced by up to 59% in Mexico City and 63% in London. The cities demonstrated a range of air quality changes in their differing geographical areas and land use types. Local meteorology and pollution events, such as forest fires, also impacted the results.

Effects of Home Confinement on the Intensity of Physical Activity during the COVID-19 Outbreak in Team Handball According to Country, Gender, Competition Level, and Playing Position: A Worldwide Study

This study investigated effects of home confinement on physical activity (PA) in Team Handball during the COVID-19 outbreak. A total of 1359 handball players participated (age: 23 +/- 6 years). Participants from Europe, Western Asia, and North Africa answered an online version of the International Physical Activity Questionnaire (IPAQ) considering "before" and "during" confinement. COVID-19 home confinement has had a negative effect on PA (vigorous, moderate, walking, and overall). The largest decrease was in the sum parameter "all PA" (MET (metabolic equivalent of task)-min/week, eta_p² = 0.903;min/week, eta_p² = 0.861). Daily sitting time increased from 2.7 to 5.0 h per weekday (p < 0.001, eta_p² = 0.669). For gender, continent, country, level of handball league, and playing position, no significant differences (group and interaction effects) were observed. The largest change in PA behavior was in walking (minutes per day: eta_p² = 0.755), with males displaying the greatest decrease (from 62 +/- 11 to 30 +/- 14 min per weekday;d = 2.67). In terms of magnitude, difference between genders was greatest for sitting time (difference in d = 1.20). In conclusion, while COVID-19 measures were essential to preserve public health, PA was compromised and sedentary behavior increased because of these public health measures regardless of gender, playing position, and competition level.